Memorial Day Closing

Memorial Day Closing

WPS Medicare will be closed on Monday, May 27, 2013, in observance of Memorial Day. If you require assistance, please contact us when we re-open on Tuesday, May 28, 2013.

 

Easy Access to C-SNAP Login

Easy Access to C-SNAP Login

Providers who use C-SNAP know it's a valuable resource for checking patient eligibility and claim status, ordering duplicate remittance notices, and much more. Now we've made it easier than ever for you to login to your C-SNAP account by adding a "C-SNAP Website" link to the right side of the header on all wpsmedicare.com web pages. If you're not already using C-SNAP, learn more and register.

 

Acceptance of Part A-to-Part B Re-bills

Acceptance of Part A-to-Part B Re-bills

Contrary to what you may have heard, WPS is accepting Part A-to-Part B re-bills. Providers should follow this link http://www.wpsmedicare.com/j5macparta/publications/news/cms_news/2013-0410-implementation-cms-ruling-1455-r.shtml for instructions on submitting re-bills using the 12X (inpatient, Part B only) and 13X (outpatient) type of bills. Please note that these instructions are temporary and valid until July 2013. At that time, standard systems will automate the re-billing process. Look to WPS for further updates on the re-bill process.

 

Looking for a Policy?

Looking for a Policy?

Have you ever needed to know if WPS Medicare has a Local Coverage Determination (LCD) for a certain CPT or HCPCS code? The fastest, easiest way to find out is by using our Crosswalk to CPT/HCPCS Codes and Associated Coverage Determinations web page. Use the "Website Tip" near the top of the page to search for your code. Once you find it, select the state-specific link beneath the corresponding policy title to review the policy.

 

Skilled Nursing Facility (SNF) Alert

Skilled Nursing Facility (SNF) Alert Update

This is an update to the issue identified where some SNF claims (TOB 21x) were being cancelled erroneously for not meeting the three day qualifying hospital stay requirement when in fact the requirement was met. After further analysis by the Common Working File (CWF), it was determined that this only impacted SNF claims where the inpatient claim (TOB 11x) posted on CWF contained dates of service less then four calendar days and the discharge date was equal to the SNF claim admission date. The CWF is fixing the problem to prevent any new SNF claims from denying inappropriately for this reason. This fix will be installed into production on 05/23/13. At this time, no provider action is necessary. Read more…

 

Memorial Day Closing C-SNAP Login Re-Bills Policy Search SNF Claims Receiving IUR in Error for No QHS

CERT

Stop refunding money, WPS Medicare is dedicated to helping you receive correct payments and avoid errors that are identified by the Comprehensive Error Rate Testing (CERT) contractor.

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Claims Denials and Rejections

System related claims processing/payment alerts reported to CMS and the Fiscal Intermediary Standard System (FISS) maintainer for research and correction. Please refer to these important messages before contacting our Customer Service Area.

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Customer Service

(866) 518-3285

Training Closures
Call center staff will be unavailable for phone calls from
8:30 am CST until 10:30 am CST on the following dates:
May 24th and 31st
June 21st and 28th

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Inpatient Review Finding

Based on CERT review findings there are errors being made when billing for inpatient claims. When billing for these types of claims it's important to have good, clear and concise documentation to support the service. We offer several training modules to help.

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5010

Version 5010 is the new version of the X12 standards for HIPAA transactions. The WPS EDI site has more information about 5010.

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